Please enter something

Assistive & Adaptive Devices

question

Benefits of AD
answer

helps w/people who have illness (CVA) injury (post THR) provide safety security and function w/min energy expenditure improves base of support
question

AD compensate for
answer

decreased muscle strength weight-bearing restrictions dec.mobility and body function, stability, balance increased pain during ambulation neurological deficits amputations of LE, or new prosthetic or orthotic device
question

How to Prepare for ambulation
answer

Medical record selection of equipement Prepare for ambulation (obtain consent) move objects check equipment apply gait belt capability (mental and physically ready) train family as needed
question

Precautions
answer

Proper footwear ck vital signs, appearance, alertness frequently gait belt guarding – stand behind and slightly to one side protect pt’s appliances (cast, tubes, iv)
question

Pre-ambulation equipment
answer

provides prep and training for Pt’s who will walk with AD gives PTA chance to give Pt. a practice session allows Pt to develop confidence in the use of the AD
question

Types of AD
answer

hospital bed bedside commode bathroom w/rail stairlift tilt table & standing table parallel bars walkers crutches canes
question

Hospital beds
answer

air fluidized support bed (CLINITRON) for infected lesions,pressure ulcers, and burn patients Low air loss therapy bed for prolonged immboilization
question

Tilt table
answer

used for pts who are attempting to physiologically accommodate to a upright position ck vitals everytime table is elevated
question

How to use a walker
answer

instruct pt. to lift or push the walker to the point that rear legs are in line with the patient’s toes
question

Disadvantage of the walker
answer

difficult to store and transport impossible to use on stairs may be difficult to perf a normal gait pattern hard to use in crowded areas need stronger UE
question

Hemiplegic walker
answer

BOS slightly larger than quad cane for pt. who dont have motor control of hand
question

Axillary Crutches
answer

easy to transport increase mobility wider variety of gait patterns and speed adjustable can be used on stairs
question

Disadvantage of crutches
answer

less stable than walker can cause injury to axillary artery and radial nerve if used wrong need good balance elderly insecure using crutches req good UE and trunk strength
question

Lofstrand Crutches
answer

more stability than cane eliminates damage of axillary structures more functional in narrow areas forearm cuff keeps crutch on when reaching allows for functional hand use
question

Disadvantages of Lofstrand
answer

less stability than axillary elderly are insecure cuff difficult to remove req. functional standing balance and UE/trunk strength
question

Cane
answer

compensate for impaired balance or improve stability more functional on stairs and confined space some adjustable limited support due to small BOSS held in UNINVOLVED EXTREMITY
question

Quad cane
answer

four point base provides larger BOS than SC pt. education req. (they can trip on it)
question

// bar fit
answer

provide 20-25degree elbow flexion hands on bar 6 ” anterior to hip 2” away from GC
question

Walker Fit
answer

Pt. standing hand grip level w/GC or ulnar styloid process 20-25degree elbow flexion
question

Axillary Crutch fit
answer

subtract 16” from pt. height Pt. supine measure axillary fold to 6-8” lateral to heel Pt. makes “L” line crutch for approx. Measure from olecranon process to the tip of the long finger of the extended arm
question

Axillary hand piece
answer

should be aligned with GC, or ulnar styloid process top of each crutch should be 2-3 width below armpit position crutch 2-4” lateral 4-6” anterior bear weights through hands not armpits
question

Cane fit
answer

position cane so tip is 2” lateral 4-6” anterior to toes top of handle is at height of GC or USP elbow 20-25 degree flexion
question

Forearm crutch fit
answer

length measured like cane top of forearm cuff located 1 to 1 1/2” distal to olecranon process
question

Considerations for Choosing AD
answer

stability vs. mobility choose LRAD appropriate for pt. weight bearing status diagnosis pt mental abilities pt physical abilities pt environment expected ambulation activites prognosis for improvement
question

Safety Considerations
answer

always push up from arms of chair vs. AD stand on Pt weaker side when guarding clear **** outta way gait belt no tennis ball on walkers in hospitals (pathogens)
question

Standing from chair w/ axillary crutches
answer

Gait belt on pt pt slides forward to edge of chair stronger leg back leans foward push up w/strong arm from chair and stronger leg once upright place crutches on arms
question

w/c to stand w/axillary crutches
answer

lock w/c caster wheel forward gait belt slide forward on w/c slide good leg back lean foward push up w/strong arm from armest of w/c and strong leg pt places both forearm crutch on each arm
question

chair to stand w/walker
answer

lock w/c caster wheel forward gait belt slide forward on w/c strong foot back lean forward pushup on armrest and stronger leg pt leans forward and hold walker
question

returning to w/c from walker
answer

lock w/c caster wheel forward gait belt pt backs up to w/c until front edge touches back legs keep strong leg back kick weaker leg forward reach for armrest and slowly sit
question

Safety ascending stairs
answer

bodyweight on crutches lift uninvolved leg onto next step then INVOLVED up up with the good
question

Safety descending stairs
answer

lower crutches and INVOLVED leg to lower step keeping BW on uninvolved leg the place BW on crutches and lower uninvolved leg down with the bad
question

pt orientation to AD
answer

explain AD was specifically fit for them tech pt and caregiver how to use AD explain how to unfold/fold and maintain AD
question

pt w/ poor cognition
answer

Poor carryover and compliance at home may create more safety issue than help need to train family/caregiver how to use AD, guard pt, and how important it is to use a gait belt
question

Weight bearing status
answer

FWB full weight bearing WBAT weight bearing as tolerated PWB passive weight bearing NWB 0% weight bearing
question

FWB
answer

100% pt weight on involved extremity no AD req unless for pain manegment
question

WBAT
answer

as much of pt. weight as tolerated on involved extremity
question

PWB
answer

limited amount of weight bearing on involved extremity % or in pounds
question

NWB
answer

no weight on involved extremity
question

TTWB
answer

toe touch weight bearing only toes contact ground encourages plantar flexion and possible muscle imbalance abnormal
question

Documentation
answer

type of device used level of assistance required distance covered type of surface quality of gait compensations used